Ventricular arrhythmia events in heart failure patients with cardiac resynchronization therapy with or without a defibrillator for primary prevention
Abstract Background It is uncertain whether cardiac resynchronization therapy with a defibrillator (CRT‐D) provides better survival benefits than a CRT‐pacemaker (CRT‐P) in heart failure patients with a reduced ejection fraction (≦35%, HFrEF) treated with contemporary HF therapy. Methods We retrospe...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-12-01
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| Series: | Journal of Arrhythmia |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/joa3.12795 |
| _version_ | 1811178196502052864 |
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| author | Toshihiro Nakamura Koji Fukuzawa Kunihiko Kiuchi Mitsuru Takami Yusuke Sonoda Hiroyuki Takahara Kazutaka Nakasone Kyoko Yamamoto Yuya Suzuki Ken‐ichi Tani Hidehiro Iwai Yusuke Nakanishi Mitsuhiko Shoda Atsushi Murakami Shogo Yonehara Ken‐ichi Hirata |
| author_facet | Toshihiro Nakamura Koji Fukuzawa Kunihiko Kiuchi Mitsuru Takami Yusuke Sonoda Hiroyuki Takahara Kazutaka Nakasone Kyoko Yamamoto Yuya Suzuki Ken‐ichi Tani Hidehiro Iwai Yusuke Nakanishi Mitsuhiko Shoda Atsushi Murakami Shogo Yonehara Ken‐ichi Hirata |
| author_sort | Toshihiro Nakamura |
| collection | DOAJ |
| description | Abstract Background It is uncertain whether cardiac resynchronization therapy with a defibrillator (CRT‐D) provides better survival benefits than a CRT‐pacemaker (CRT‐P) in heart failure patients with a reduced ejection fraction (≦35%, HFrEF) treated with contemporary HF therapy. Methods We retrospectively analyzed the ventricular arrhythmia (VAs; sustained ventricular tachycardia/fibrillation) events in HFrEF patients who underwent CRT without a prior history of VAs or aborted sudden cardiac death before the CRT implantation. Between January/2010 and December/2020, a CRT device was implanted in 79 HFrEF patients (mean age: 69 ± 12 years, male: 57, ischemic cardiomyopathy: 16). CRT‐D and CRT‐P devices were implanted in 50 and 29 patients, respectively, at each physician's discretion. CRT‐Ds were indicated in younger patients than were CRT‐Ps (66 ± 12 vs. 73 ± 12 years, p = 0.03), but the gender distribution did not differ (female, 24% [12 of 50] vs. 35% [10 of 29], p = 0.44). The VA events during a median follow‐up of 3.5‐years (interquartile range [IQR]:1.6–5.5) and their predictors were analyzed. Results VA events occurred in 9 patients with CRT‐Ds (18%) and one with a CRT‐P (3%, p = 0.08). The VA event rate was significantly lower in patients without a prior non‐sustained ventricular tachycardia (NSVT: ≥3 beats; rate, ≥120 bpm; lasting <30 s, HR 0.05; 95% CI 0.01–0.30; p < 0.01) and females (HR 0.11; 95% CI 0.01–0.93; p = 0.04). Of note, no female patients without a prior history of NSVT experienced VA events. Conclusion HFrEF CRT candidates without a prior history of NSVT and females may obtain less benefit from a primary preventive defibrillator indication. |
| first_indexed | 2024-04-11T06:14:25Z |
| format | Article |
| id | doaj.art-a72f08f805554cb7b295f2e05152b1fe |
| institution | Directory Open Access Journal |
| issn | 1880-4276 1883-2148 |
| language | English |
| last_indexed | 2024-04-11T06:14:25Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-a72f08f805554cb7b295f2e05152b1fe2022-12-22T04:41:06ZengWileyJournal of Arrhythmia1880-42761883-21482022-12-013861056106210.1002/joa3.12795Ventricular arrhythmia events in heart failure patients with cardiac resynchronization therapy with or without a defibrillator for primary preventionToshihiro Nakamura0Koji Fukuzawa1Kunihiko Kiuchi2Mitsuru Takami3Yusuke Sonoda4Hiroyuki Takahara5Kazutaka Nakasone6Kyoko Yamamoto7Yuya Suzuki8Ken‐ichi Tani9Hidehiro Iwai10Yusuke Nakanishi11Mitsuhiko Shoda12Atsushi Murakami13Shogo Yonehara14Ken‐ichi Hirata15Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanAbstract Background It is uncertain whether cardiac resynchronization therapy with a defibrillator (CRT‐D) provides better survival benefits than a CRT‐pacemaker (CRT‐P) in heart failure patients with a reduced ejection fraction (≦35%, HFrEF) treated with contemporary HF therapy. Methods We retrospectively analyzed the ventricular arrhythmia (VAs; sustained ventricular tachycardia/fibrillation) events in HFrEF patients who underwent CRT without a prior history of VAs or aborted sudden cardiac death before the CRT implantation. Between January/2010 and December/2020, a CRT device was implanted in 79 HFrEF patients (mean age: 69 ± 12 years, male: 57, ischemic cardiomyopathy: 16). CRT‐D and CRT‐P devices were implanted in 50 and 29 patients, respectively, at each physician's discretion. CRT‐Ds were indicated in younger patients than were CRT‐Ps (66 ± 12 vs. 73 ± 12 years, p = 0.03), but the gender distribution did not differ (female, 24% [12 of 50] vs. 35% [10 of 29], p = 0.44). The VA events during a median follow‐up of 3.5‐years (interquartile range [IQR]:1.6–5.5) and their predictors were analyzed. Results VA events occurred in 9 patients with CRT‐Ds (18%) and one with a CRT‐P (3%, p = 0.08). The VA event rate was significantly lower in patients without a prior non‐sustained ventricular tachycardia (NSVT: ≥3 beats; rate, ≥120 bpm; lasting <30 s, HR 0.05; 95% CI 0.01–0.30; p < 0.01) and females (HR 0.11; 95% CI 0.01–0.93; p = 0.04). Of note, no female patients without a prior history of NSVT experienced VA events. Conclusion HFrEF CRT candidates without a prior history of NSVT and females may obtain less benefit from a primary preventive defibrillator indication.https://doi.org/10.1002/joa3.12795cardiac resynchronization therapyheart failure with reduced ejection fractionprimary preventionventricular arrhythmia |
| spellingShingle | Toshihiro Nakamura Koji Fukuzawa Kunihiko Kiuchi Mitsuru Takami Yusuke Sonoda Hiroyuki Takahara Kazutaka Nakasone Kyoko Yamamoto Yuya Suzuki Ken‐ichi Tani Hidehiro Iwai Yusuke Nakanishi Mitsuhiko Shoda Atsushi Murakami Shogo Yonehara Ken‐ichi Hirata Ventricular arrhythmia events in heart failure patients with cardiac resynchronization therapy with or without a defibrillator for primary prevention Journal of Arrhythmia cardiac resynchronization therapy heart failure with reduced ejection fraction primary prevention ventricular arrhythmia |
| title | Ventricular arrhythmia events in heart failure patients with cardiac resynchronization therapy with or without a defibrillator for primary prevention |
| title_full | Ventricular arrhythmia events in heart failure patients with cardiac resynchronization therapy with or without a defibrillator for primary prevention |
| title_fullStr | Ventricular arrhythmia events in heart failure patients with cardiac resynchronization therapy with or without a defibrillator for primary prevention |
| title_full_unstemmed | Ventricular arrhythmia events in heart failure patients with cardiac resynchronization therapy with or without a defibrillator for primary prevention |
| title_short | Ventricular arrhythmia events in heart failure patients with cardiac resynchronization therapy with or without a defibrillator for primary prevention |
| title_sort | ventricular arrhythmia events in heart failure patients with cardiac resynchronization therapy with or without a defibrillator for primary prevention |
| topic | cardiac resynchronization therapy heart failure with reduced ejection fraction primary prevention ventricular arrhythmia |
| url | https://doi.org/10.1002/joa3.12795 |
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